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Biomedical subjects

R K Kerlan

Publications and source records attributed to R K Kerlan.

At least 73 records · Page 4Linked to original sources
PubMed1985

Abdominal abscess with low-output fistula: successful percutaneous drainage.

Abdominal abscesses in 72 patients were drained percutaneously. Sinograms were obtained at the time of drainage and repeated three to six days later. In 32 patients, a low-output fistulous communication to the alimentary canal, biliary tract, or pancreatic duct was demonstrated. Percutaneously placed drainage catheters provided successful treatment in 27 of these 32 patients. We conclude that low-output fistulous communications to abdominal cavities occur frequently, but can be managed successfully with percutaneous techniques in the majority of patients.

Abdomen↗
PubMed1985

Esophageal rupture: complication of balloon dilatation.

Recent studies have emphasized the safety of fluoroscopically guided balloon dilatation for treatment of severe esophageal strictures. A case of esophageal rupture that followed dilatation of a distal esophageal stricture with a 20-mm balloon catheter is reported.

Adult↗
PubMed1985

Percutaneous cholecystolithotomy: preliminary experience.

Percutaneous removal of gallstones was employed as the definitive form of therapy in three patients with acute cholecystitis. Percutaneous cholecystolithotomy may be an alternative form of therapy for selected patients with gallbladder calculi.

Acute Disease↗
PubMed1985

Hepatic vascular anatomy on magnetic resonance imaging.

This study evaluated the ability of magnetic resonance imaging (MRI) to depict the hepatic vasculature and surgical anatomy of the liver using the transaxial, coronal, and sagittal planes. Retrospective analysis of the abdominal MRI examinations of 94 patients was performed. The spin-echo imaging technique was used to obtain transaxial images in all patients and coronal and sagittal sections in 35 of these patients. Overall, the hepatic vasculature was better delineated on the longer repetition rates (2000 msec TR) and the first echo images (28 msec TE). The inferior vena cava, right and middle hepatic veins, and main and right portal veins were seen in 100% of the cases in the transaxial plane. The left hepatic vein was seen in 98%, the left portal vein in 93%, and the hepatic artery in 44% in the transaxial plane. In the sagittal and coronal planes, the inferior vena cava and main and right portal veins were seen in 100% of cases. The other hepatic vasculature was less frequently demonstrated. In the sagittal plane, the right hepatic vein was seen in 85% of the cases, the left hepatic vein in 62%, the middle hepatic vein in 90%, the left portal vein in 90%, and the hepatic artery in 14%. In the coronal plane, the right hepatic vein was seen in 85% of cases, the left hepatic vein in 14%, the middle hepatic vein in 79%, the left portal vein in 71%, and the hepatic artery in 7%. These results are from preliminary work. Further developments with MRI technology may render better visualization of hepatic vasculature.

Hepatic Artery↗
PubMed1985

Percutaneous removal of renal staghorn calculi.

Using a percutaneous approach, 18 of 20 staghorn calculi were completely removed from the upper urinary tract. The initial nephrostomy was performed in the radiology department with local anesthesia. Tract dilatation and stone removal ensued on the next day in the operating room under general anesthesia. Minor complications, including postoperative temperature spikes and pyelonephritis, occurred in seven patients. Two major complications, urosepsis and hemorrhage requiring transfusion, were encountered.

Adult↗
PubMed1985

Radiologic intervention in oriental cholangiohepatitis.

Interventional radiologic techniques can make a useful contribution to the management of patients with recurrent symptoms following surgical palliation of oriental cholangiohepatitis. Percutaneous removal of multiple, soft, pigmented biliary stones that form in this disease can be achieved by a combination of basket retrieval and crushing, as well as suction and irrigation techniques. Ducts that are obstructed by strictures can be drained by percutaneous catheters. Complete or partial symptomatic relief was obtained in six of eight patients, obviating additional surgical intervention.

Adult↗
PubMed1985

The coracoid transfer for recurrent anterior instability of the shoulder in adolescents.

Thirty-six shoulders with recurrent anterior dislocation or subluxation in thirty-four adolescent patients were treated with a modified Bristow procedure. The average length of follow-up was five years and ten months. Postoperatively, two patients had recurrent anterior subluxation on one occasion and none had recurrent anterior dislocation. The average loss of external rotation was 10 degrees. Despite the fact that young patients have a high rate of recurrence after anterior dislocation or subluxation of the shoulder, the modified Bristow procedure is an effective method of treating recurrent anterior instability of the shoulder in adolescents.

Adolescent↗
PubMed1985

Shoulder impingement syndrome in athletes treated by an anterior acromioplasty.

Shoulder pain caused by a impingement syndrome commonly affects an athlete's performance. Thirty-five shoulders in 33 athletes had an impingement syndrome treated by an anterior acromioplasty after failure of conservative treatment. Thirty-one of 35 shoulders (89%) were subjectively judged improved by the patients from their preoperative status. The moderate and severe pain was reduced from 97% of the shoulders preoperation to 20% postoperation. The pain at rest and with activities of daily living was reduced from 71% of the shoulders preoperation to 9% postoperation. However, only 15 of 35 operated shoulders (43%) allowed return to the same preinjury level of competitive athletics, and only four of 18 athletes involved in pitching and throwing returned to their former preinjury status. This operation is satisfactory for pain relief but does not allow an athlete to return to his former competitive status. A prolonged rehabilitation program may improve the results.

Acromion↗
PubMed1984

Percutaneous renal and ureteral stone removal.

Percutaneous removal of upper urinary tract calculi has become an accepted alternative to surgical removal. Calculi may be removed through large nephrostomy tracts under fluoroscopic or endoscopic control. Close cooperation between the radiologist and urologist should increase the success rate of the procedure.

Anesthesia↗
PubMed1984

Biliary endoprostheses. Insertion using a combined peroral-transhepatic method.

The transhepatic placement of adequately sized endoprostheses for the palliation of malignant biliary obstruction is painful and requires large hepatic parenchymal tracks. Endoscopically placed biliary stents are smaller, but may not be adequate for long-term patency. The authors have used a combined peroral-transhepatic approach successfully to pull large endoprostheses through the alimentary track and into the biliary tree.

Aged↗
PubMed1984

Interventional biliary radiology.

The biliary tract may be approached through surgical drainage tracts, percutaneously through the liver, and perorally through the duodenum. Removal of retained stones through a surgical drainage tract can be performed on outpatients with 90%-95% success in experienced hands. The percutaneous approach through the liver is useful to drain malignant obstructions before surgical or drug treatment and can offer catheter stent palliation for tumors in the porta hepatis. Benign strictures also may be drained and dilated transhepatically. Ascites and multiple intrahepatic obstructions are relative contraindications to transhepatic entry. Hemorrhage is the most frequent serious complication, occurring in about 5% of procedures. Indwelling endoprostheses are preferred to external catheters to reduce the psychologic trauma of the catheter. A new procedure for inserting large endoprostheses by a combined peroral/transhepatic approach has the advantage of requiring only a small transhepatic tract.

Biliary Tract Diseases↗
PubMed1984

Sonographic evaluation of experimental acute renal arterial occlusion in dogs.

Eleven segmental and eight total renal artery occlusions were evaluated by sonography in transplanted kidneys of 19 adult mongrel dogs. The segmental occlusions were serially scanned daily or every other day for up to 35 days. The total occlusions were scanned daily for up to 10 days. Each occlusion was confirmed angiographically, and kidneys were examined pathologically. Acute segmental renal artery occlusion produces a sequence of sonographic changes, beginning with a focal hypoechoic mass at 24 hr, which stays unchanged for 5-7 days. At 7 days, internal echoes appear, and the infarct slowly consolidates to an echogenic, slightly depressed focus at 17 days. Total renal artery occlusion produced no appreciable change in cortical echogenicity and only slight increase in size. Acute segmental renal infarction can be detected early in its course and demonstrates a sequence of changes that may aid in dating the infarct. Total renal infarction may appear normal sonographically, and further studies are needed to confirm that diagnosis.

Animals↗
PubMed1984

Cystic insulinoma.

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Adenoma, Islet Cell↗